More than 80 percent of the youth exposure resulted from advertising for one brand of e-cigarettes – blu eCigs, purchased by the giant cigarette company Lorillard in early 2012. Advertising spending on blu increased from $2 million in 2011 to more than $14 million in 2012, the researchers reported.

Lorillard and other e-cigarette manufacturers claim that their advertising is carefully directed at adult smokers. But this study shows that e-cigarette ads are hitting a much broader target, including tens of millions of kids. Congress banned cigarette ads on TV starting in 1971 because of the unique impact TV advertising can have on young people.

In April, the Food and Drug Administration issued its long-overdue proposed rule to begin regulating e-cigarettes, cigars and other tobacco products not currently under its jurisdiction. Unfortunately, the proposed rule does not address e-cigarette marketing. The alarming increase in youth exposure to e-cigarette ads underscores why the FDA and the Obama Administration must move as quickly as possible to finalize the proposed rule, and do so within 12 months. The FDA must also immediately develop follow-up regulations that close gaps in the proposed rule by restricting marketing and flavors that appeal to kids. There can be no excuse for further delay.

Marketing for blu and other e-cigarette brands has shamefully used many of the same themes and tactics long used to promote regular cigarettes to kids. Featuring celebrities such as actor Stephen Dorff and former Playboy model Jenny McCarthy, TV ads for blu portray e-cigarette use as rugged, glamorous, sexy and cool. As the new Pediatrics study notes, some ads present e-cigarette use as an adult activity (“We’re all adults here,” one ad proclaims), echoing a theme long used to make regular cigarettes appealing to kids. The researchers point out that U.S. District Court Judge Gladys Kessler, in her 2006 verdict that the major cigarette manufacturers had violated civil racketeering laws, wrote, “Emphasizing that smoking is an adult activity underscores the desirability of engaging in adult behavior for adolescents who are particularly motivated to appear mature.”

In addition to TV ads, e-cigarette marketing has included slick ads in magazines with large youth readerships, race car and music festival sponsorships, a cartoon pitchman and sweet flavors such as gummi bear and cotton candy. Lorillard’s blu has been among the worst offenders. The company ran an ad in this year’s Sports Illustrated swimsuit issue that placed the blu logo on a sexy model’s bikini, while a recent video for blu featured the teen-oriented twerking dance craze. This marketing shows that Lorillard officials can’t be taken seriously when they say their intended customers are “smokers of legal age” and that “blu eCigs is actively and effectively ensuring that its advertising is directed at adult smokers,” as they told the FDA in a recent letter.

Given these marketing tactics, it isn’t surprising that the Centers for Disease Control and Prevention (CDC) found youth e-cigarette use more than doubled from 2011 to 2012. The percentage of high school students who reported ever using e-cigarettes jumped from 4.7 percent to 10 percent. The CDC estimated that 1.78 million U.S. youth had tried e-cigarettes as of 2012.

Responsibly marketed and properly regulated, e-cigarettes could benefit public health if they help significantly reduce the number of people who smoke conventional cigarettes and become sick and die as a result. However, if they continue to be irresponsibly marketed, they could make smoking look glamorous again and undermine decades of work to reduce youth smoking. Effective regulation by the FDA and the states is needed to minimize the potential harms of e-cigarettes and maximize any potential benefits.